Rehabilitation of oropharyngeal dysphagia in children with cerebral palsy: A systematic review of the speech therapy approach

Hirata, Gisela Carmona; Santos, Rosane Sampaio

doi:10.7162/s1809-97772012000300016

Cited by 9 publications

(7 citation statements)

References 13 publications

(13 reference statements)

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“…In particular, reduced nutritional intake due to oropharyngeal dysfunction [4], temporo-mandibular joint contractions, and sensory impairment leads to malnutrition in most of the cases, with severe motor dysfunction [4,5].…”

Section: Introductionmentioning

confidence: 99%

Gastrostomy Placement and Management in Children: A Single-Center Experience

et al. 2019

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BACKGROUND: To prevent malnutrition and food aspiration in children with chronic neuromuscular problems, enteral nutrition provided by gastrostomy is recommended. Long-term follow-up data about surgical and medical complications of PEG are available, but few papers have addressed all of the issues in the same series. METHODS: This retrospective study enrolled patients under 18 years who had a gastrostomy tube placed at our institution between 2003 and 2017. The aim is to evaluate outcomes after gastrostomy placement, focusing both on surgical complications (early and late), and its effect on their nutritional status, on the prevention of pulmonary infections, and their parents’ opinion. RESULTS: Eighty-four gastrostomies were placed in total (35 F; 49 M). Seventy-seven patients had a severe neurocognitive impairment (GMFCS 5). The principal indication for gastrostomy was severe dysphagia (53.3%). No gastrostomy-related death was observed. Early surgical complications were observed in five of 84 (5,9%) patients; late complications were observed in 15 of 84 (17.8%) patients. Twenty-two patients were diagnosed with subsequent gastroesophageal reflux; five patients developed dumping syndrome (6%). Complete medical follow-up data were available for 45 patients. A progressive improvement of nutritional status was observed in 29 patients, and 11 maintained the same percentile; the occurrence of respiratory infections and need for hospitalization decreased. In 90% of cases, parents were fully satisfied with the g-tube. CONCLUSION: This study confirms the positive nutritional outcomes of gastrostomy-tube with an associated small risk of surgical complications and a reduction in the number of respiratory infections, with most parents scoring their experience as positive.

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Section: Introductionmentioning

confidence: 99%

Gastrostomy Placement and Management in Children: A Single-Center Experience

et al. 2019

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“…Согласно выводам систематического обзора за 1977-2010 гг., посвященного реабилитации пациентов с неврологическими нарушениями и дисфагией, в научной литературе недостаточно исследований, посвященных вопросам реабилитации детей с ДЦП с синдромом орофарингеальной дисфагии [20].…”

Section: дисфагияunclassified

Morphofunctional features of organs in children with cerebral palsy

Камалова¹,

Rakhmaeva²,

Малиновская³

2020

jour

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Problems associated with impaired gastrointestinal function are common in children with cerebral palsy. Typical gastrointestinal manifestations of cerebral palsy include dysphagia, gastroesophageal reflux disease and constipation, which in chronic course lead to the development of nutritional status disorders, micronutrient insufficiency, osteopenia, reduced immunity and rehabilitation potential. Often it is the gastroenterological aspects of management of children with cerebral palsy that determine the quality of life of the child and his family.

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“… 10 , 11 If mild feeding problems are recognized, rehabilitation therapy and teaching of right feeding techniques by experts is recommended. 12 , 13 In patients with swallowing problems, liquid or pureed foods can be used. In patients with chocking problems during eating liquid foods, thickening agents can be added.…”

Section: Introductionmentioning

confidence: 99%

Nutrition of patients with severe neurologic impairment

Орел

Homan

Blagus

et al. 2017

Radiology and Oncology

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BackgroundCommercial enteral formulas are generally recommended for gastrostomy feeding in patients with severe neurologic impairment. However, pureed food diets are still widely used and even gaining popularity among certain groups. We tried to compare the effectiveness of gastrostomy feeding for treatment of severe malnutrition with either enteral formulas or pureed feeds.Patients and methodsA 6-month nutritional intervention was made with 37 malnourished children, adolescents and young adults (2–26 years old) with severe neurologic impairment (Gross Motor Function Classification system [GMFCS] grade V). The individual needs were calculated. Participants were fed by gastrostomy with either enteral formulas (n = 17) or pureed food (n = 20). Measurements to assess nutritional status were made at the beginning and at the end of intervention.ResultsThe Z scores for weight-for-age and for the body-mass index increased more in enteral formula than in pureed food group (2.07 vs. 0.70, p = 0.0012; and 3.75 vs. 0.63, p = 0.0014, respectively). Fat mass index increased more in enteral formula than in pureed food group (1.12 kg/m2 vs. 0.38 kg/m2; p = 0.0012). Patients in the enteral formula group showed increase in lean body mass expressed as fat-free mass index (0.70 kg/m2), while those in pureed food group did not (-0.06 kg/m2) (p = 0.0487).ConclusionsThe results suggest that even professionally planned pureed food diet is less effective than commercial enteral formula for nutritional rehabilitation of malnourished patients with severe neurologic impairment. However, larger and if possible randomised clinical studies should be made to confirm our findings.

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Rehabilitation of oropharyngeal dysphagia in children with cerebral palsy: A systematic review of the speech therapy approach

Cited by 9 publications

References 13 publications

Gastrostomy Placement and Management in Children: A Single-Center Experience

Gastrostomy Placement and Management in Children: A Single-Center Experience

Morphofunctional features of organs in children with cerebral palsy

Nutrition of patients with severe neurologic impairment

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